Protection from Violence in the Emergency Department

Revised April 2016 with current title, June 2011

Revised April 2008 titled “Protection from Physical Violence in the Emergency Department Environment”

Reaffirmed October 2001 and  October 1997

Originally approved January 1993 titled “Protection from Physical Violence in the Emergency Department”


The American College of Emergency Physicians (ACEP) believes that workplace violence is a preventable and significant public health problem and that optimal patient care can be achieved only when patients, health care workers, and all other persons in the emergency department (ED) are protected against violent acts occurring within the department. As such, ACEP advocates for increased awareness of violence against health care workers in the ED and for increased safety measures in all EDs. Further, ACEP encourages all states to enact legislation that provides a maximum category of offense and criminal penalty against individuals who commit violence against health care workers in the ED.

To ensure the safety and security of the ED environment, the hospital and its administrators have the following responsibilities:

  • Provide an ED security system based upon institution-specific risk assessment that includes adequate security personnel, sufficient training of personnel, physical barriers, surveillance equipment, and other security components.
  • Conduct ongoing assessments of the ED security system performance.
  • Coordinate the hospital security system with local law enforcement agencies.
  • Develop written ED protocols with input from employees for violent situations occurring in the ED to ensure the safety of patients, visitors, and health care workers alike.
  • Educate staff through formal, regular training on early recognition of individuals with potential to become violent, techniques for de-escalation, non-violent crisis intervention, and importance of seeking assistance.
  • Develop and enforce a mandatory reporting policy that requires employees to promptly report any verbal or physical assault. Such policies should clearly state that reporting will not result in any adverse action by the hospital such as termination, threatening to terminate, demoting, suspending, or in any manner discriminating against an employee who reports an assault.
  • Adopt a zero tolerance policy for employees, patients, and visitors that states that any violence in the ED is not acceptable. Educate employees that any assault is not considered “part of the job.”
  • Provide appropriate post-incident support for employees involved in violent events including prompt medical treatment, debriefing, counseling, and employee assistance.
  • Pursue maximum criminal prosecution, when deemed appropriate, against those individuals who commit violent acts against health care workers.

Additionally, ACEP recognizes that the EMS system is an integral component of emergency care and supports and encourages efforts to protect EMS personnel against physical violence in the prehospital environment.

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